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Brain death: MR and MR angiography
K Ishii1, T Onuma, T Kinoshita
1Department of Radiology, Sendai Japan City Hospital, Japan.
Summary:
Four patients in whom brain deaths was identified on the basis of neurologic and electroencephalographic findings were examined with MR imaging and MR angiography. MR images showed diffuse swelling of the cerebral gyri and cerebellar cortex, which prolongation of both the T1 and T2 signal (representing hypoxic ischemic brain injury), downward displacement of the diencephalon and the brain stem (central and tonsillar herniation), and loss of flow void in the intracranial portions of both internal carotid arteries. MR angiograms did not show the intracranial vessels above the level of the supraclinoid portion of the internal carotid arteries. MR angiography and MR imaging are noninvasive and reliable methods for use in determining brain death.
Insights
Magnetic resonance imaging (MRI) and MR angiography can reliably detect brain death. These noninvasive methods identified characteristic changes in patients with confirmed brain death, including brain swelling and lack of blood flow.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Brain death diagnosis relies on clinical and electroencephalographic findings.
- Advanced imaging techniques are being explored for objective confirmation.
Purpose of the Study:
- To evaluate the utility of MR imaging and MR angiography in diagnosing brain death.
- To correlate imaging findings with established criteria for brain death.
Main Methods:
- Four patients with confirmed brain death underwent MR imaging and MR angiography.
- Analysis of MR images for signs of hypoxic ischemic brain injury and herniation.
- Assessment of intracranial blood flow using MR angiography.
Main Results:
- MR imaging revealed diffuse cerebral and cerebellar swelling with prolonged T1 and T2 signals.
- Evidence of central and tonsillar herniation was observed.
- MR angiography demonstrated absent flow in intracranial carotid arteries above the supraclinoid portion.
Conclusions:
- MR imaging and MR angiography are noninvasive and reliable tools for determining brain death.
- Imaging findings correlate with neurologic and electroencephalographic criteria for brain death.
- These techniques offer objective evidence in brain death determination.